complaint·September 29, 2022

Regarding Allegation #1 : this investigation revealed a review of R1's " Physician Report " (dated 11/10/19) documented under " Mental Condition " Able to communicate Needs: Yes; under " Capacity for Self Care " Resident able to feed self: Yes. A review of the " Resident Appraisal " (dated 01/23/20) documented under the " Services Needed " Help with eating (need for adaptive devices or assistance from another person): No. A review of R1's " Functional Capability Assessment " (dated 01/23/20) documented under " Eating " that the resident feeds self completely and under " Communication " that the resident expresses self verbally. A review of R1's " Appraisal Needs and Services Plan " (dated 01/23/20) documented that facility staff will monitor the resident to ensure that the resident is using their independent skills. A review of the facility's weekly menu documented the daily diet to be of quality necessary to meet the needs of the residents. The facility has an approved Waiver to utilize Bella Vista Retirement (#197608297) as the food headquarter to store, prepare, serve, and transport meals to Arbor Vista was granted by CCLD. LPA/RA reviewed Witness #1 [local law enforcement police report (dated 09/13/21)] attempts made by W1 & W3 to encourage R1 to eat the food served at the facility; however, R1 refused food service. Resident #1 was also encouraged to go and see a doctor to be assessed; however, the resident refused medical services. W1 & W3 notified W4. Interviews conducted by facility staff corroborated that R1 had stopped eating for five (5) days and refused medical treatment from doctors. Facility Staff contacted (9-1-1) to respond to the facility as Resident #1 was later transported to the hospital on 09/13/21. A review of the " Pre-hospital Care Report " (dated 09/13/21) documented that the patient (R1) was advised multiple times by assisted-living staff to go with transport (9-1-1) to the hospital; but, patient (R1) repeatedly refused and stated that this was too much for the patient (R1) right now. Patient (R1) was advised of risks and consequences and advised to seek alternative medical care. Patient (R1) understood the consequences of refusal of medical services by hospital staff. Patient (R1) signed an AMA (against medical advice). Resident #1 did not return to the facility following hospital discharge. Based on the evidence gathered and interviews conducted and records reviewed, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur; therefore, the allegation of NEGLECT/LACK OF SUPERVISION: Facility did not ensure that resident was adequately fed is found to be UNSUBSTANTIATED. Regarding Allegation #2 : this investigation revealed a review of R1's " Emergency I.D. and Informatio n" (dated 11/23/09) documented that Resident #1 is their own responsible person and present/legal guardian. A review of the " Unsual Incident/Injury Report " (dated 09/13/21) documented the incident and immediate action taken by facility staff (including persons notified) that included R1's family member (Witness #2) and CCLD. Interviews conducted by facility staff corroborated that R1 was their own responsible person; but, R1 did have family. Based on the evidence gathered and interviews conducted and records reviewed, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur; therefore, the allegation of REPORTING REQUIREMENTS: Facility staff did not notify resident’s representative of a change in the resident’s condition in a timely manner is found to be UNSUBSTANTIATED. An exit interview has been conducted and a copy of the Complaint Report was provided to the Administrator, Kim Commodore.